Individual provider · Type 1 NPI
Susan Park, DDS
Orthodontics and Dentofacial Orthopedics Dentistry · North Syracuse, NY
Practice location
709 N Main St
North Syracuse, NY 13212-1669
Mailing address
3850 N Causeway Blvd, Suite 800
Metairie, LA 70002-1752
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | 048609-1 (NY) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
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About NPI 1821147190
Susan Park, DDS's National Provider Identifier is 1821147190, issued on Jan 9, 2007. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in North Syracuse, NY. The record was last updated on Aug 24, 2010.